MEDICARE: PARK AVENUE ACOUSTICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	15000007320	NY

General Provider Information

NPI Number	:	1225297625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARK AVENUE ACOUSTICS, INC.

Provider Business Mailing Address
First Line	:	274 MADISON AVE
Second Line	:	SUITE 1203
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:	212-689-6665
Fax Number	:	212-689-8871

Provider Business Practice Location Address
First Line	:	274 MADISON AVE
Second Line	:	SUITE 1203
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:	212-689-6665
Fax Number	:	212-689-8871

Authorized Official
Title or Position	:	DOCTOR OF AUDIOLOGY/ OWNER
Name	:	DR. DIANA T KING
Credential	:	AU.D.
Telephone Number	:	212-689-6665

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	06/02/2008

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